Real-World Impact of Remote Patient Management on Care Consumption and Care Time in Heart Failure: Retrospective Cohort Study

Background Remote patient management (RPM) is a strategy to track daily health data in patients with heart failure (HF) to enable early detection and treatment of decompensation to prevent hospital readmissions. The implementation of RPM alters standard care and redistributes provider responsibilities. Although randomized controlled trials demonstrate positive clinical outcomes, the impact of implementing RPM on patients’ health care usage, as well as the care time and workload of health care providers in a real-world setting, remains unclear. Objective The objective of this retrospective study is to explore the effects of implementing RPM for HF on patients’ cardiac care consumption and caregiver workload within a regional care network through the use of real-world data. Methods Two hospitals in the same regional care network with aligned care pathways for usual care (UC) were compared: one with RPM (hospital 1) and one without (hospital 2). Between June 2021 and July 2022, patients with HF were included from a clinical registry with a 1-year follow-up. Cardiac health care consumption was quantified by the number and duration of consultations (in-person, phone, and RPM) with nurse practitioners specialized in HF care and cardiologists. HF-related readmissions were also collected. Three groups were analyzed: hospital 1 RPM, hospital 1 UC, and hospital 2 UC. Results A total of 131 patients were included (hospital 1 RPM: 34, hospital 1 UC: 64, hospital 2 UC: 33). Consultation frequency and duration were significantly higher in the hospital 1 RPM cohort compared to the hospital 1 UC and the hospital 2 UC cohorts (frequency: mean 18.5, SD 9.3 vs mean 9.3, SD 6.0 and mean 11.6, SD 6.3; P <.001; duration: mean 233.2, SD 95.2 min vs mean 121.2, SD 47.9 min and mean 113.0, SD 66.0 min; P <.001), mainly due to increased number of consultations of nurse practitioners specialized in HF care (hospital 1 RPM: mean 15.3, SD 8.4 vs hospital 1 UC: mean 5.3, SD 2.4 and hospital 2 UC: mean 8.6, SD 6.1; P <.001). No significant differences were observed regarding cardiologist care time ( P =.27), cardiologist number of consultations ( P =.43), or HF-related readmissions ( P =.47). Conclusions In this real-world study, the implementation of RPM for patients with HF was associated with a higher nursing workload, with no observed differences in cardiologists’ consultations or patient outcomes. These findings highlight the need for optimization at organizational and technological levels and underline the importance of real-world evaluation of the implementation of innovations.